Watching an emergency room close

It’s hardly a mystery why so many hospitals nationwide have pleaded with state officials to accept Medicaid expansion through the Affordable Care Act: they can’t afford the alternative.

When someone is seriously ill and they show up at an emergency room, the hospital is prohibited from turning him or her way. When patients are poor, they can’t pay for the care they receive, putting an enormous strain on hospital budgets. The logic isn’t complicated: administrators and medical professionals want to expand coverage, reduce the number of uninsured patients, and bolster hospital finances to everyone’s benefit.

But as we’ve seen too often, Republican policymakers are inclined to ignore hospitals’ concerns. Why? Because Medicaid expansion is part of “Obamacare.” And “Obamacare” is bad. Or something.

The consequences are sadly predictable. In Louisiana last week, a Baton Rouge E.R. announced it would have no choice but to close its doors within 60 days. The facility’s president and CEO said officials “left no stone unturned as we’ve sought solutions,” but the uninsured patients using the facility created a financial strain that was simply too great.

Michael Hiltzik made a persuasive case that the responsibility falls at the feet of Gov. Bobby Jindal (R), who refuses to consider Medicaid expansion.

In Baton Rouge, the Mid City ER, which recorded 45,000 patient visits last year, started facing a crisis in 2013, when it inherited the case load from a nearby ER that closed. According to the Baton Rouge Advocate, Mid City’s losses were projected to hit $25 million to $30 million this year. The Jindal administration stepped in with a promised infusion of $18 million, but that turned out to be a stopgap aimed at staving off an ER closure threatened last summer. Now the ER is set to close within 60 days.

Jindal, who still evidently harbors fantasies of running for president, deserves blame for the situation. As other GOP governors have seen the light on Medicaid expansion – 10 have reached agreements with the federal government recently – Jindal has become ever more obstinate.

The real-world consequences matter.

Hiltzik’s report added that once this Baton Rouge facility closes, “patients needing emergency treatment will have to travel as much as 30 minutes longer to reach the nearest ERs.”

The problem is not unique to Louisiana – we’ve seen several rural hospitals in Georgia close under similar circumstances following GOP officials’ decision to also reject Medicaid expansion – but it is unique to Republican-led states that prioritize their partisan contempt for the Affordable Care Act over arithmetical reality.